Guideline for the Management of Postoperative Nausea and Vomiting

McCracken, Geoff; Houston, Patricia; Lefebvre, Guylaine

doi:10.1016/s1701-2163(16)32895-x

Cited by 85 publications

(100 citation statements)

References 62 publications

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“…From a patient's perspective, postoperative nausea and vomiting is one of the most distressing adverse postoperative outcomes, 26 and its avoidance is a marker of quality anesthetic care. [27][28][29][30] There were 27 reports of patient complaints, which the respondents thought could be related to drug shortages. We have no details surrounding these events, but in two cases, legal action was reportedly taken, suggesting that patients are beginning to be negatively affected by the current drug shortage.…”

Section: Discussionmentioning

confidence: 99%

Drug shortages in Canadian anesthesia: a national survey

Hall

Bryson

Flowerdew

et al. 2013

Can J Anesth/J Can Anesth

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Background Canadian physicians are faced with an increasing frequency of drug shortages. We hypothesized that drug shortages have a clinical impact on anesthesia care in Canada. Methods We conducted a self-administered survey of anesthesiologists in Canada using the membership list of the Canadian Anesthesiologists' Society. For survey development, we identified key domains, including types of drug shortages, impact on the ability of anesthesia practitioners to provide general anesthesia care, and impact on patient outcomes. We undertook assessments of face validity, clinical sensibility, and content validity. Respondents were surveyed from January-April 2012. Results Completed valid questionnaires were submitted by 1,187 respondents (61.4%), and 779 (65.7%) of respondents described a shortage of one or more anesthesia or critical care drugs. Changes in anesthesia practice resulting from drug shortages were common; 586 (49%) respondents thought they had given an inferior anesthetic, and 361 (30%) reported administering medications with which they were unfamiliar. Respondents also reported that drug shortages were, at times, responsible for changes in the conduct of patient care, with 28 (2.4%) noting cancellation or postponement of surgery and 92 (7.8%) witnessing a drug error. One hundred sixty-five (13.9%) respondents regarded drug shortages as having prolonged recovery from anesthesia, and 124 (10.5%) viewed drug shortages as resulting in an increased number of postoperative complications, such as postoperative nausea and vomiting. Interpretation Drug shortages are common in anesthetic practice in Canada. This state of affairs may have a negative effect on how anesthesiologists practice anesthesia and may be associated with adverse patient outcomes. 123Can J Anesth/J Can Anesth (2013) 60:539-551 DOI 10.1007/s12630-013-9920-z Résumé Contexte Les me´decins canadiens font de plus en plus souvent face a`des pe´nuries de me´dicaments. Nous avons e´mis l'hypothe`se que les pe´nuries de me´dicaments avaient un impact sur les soins en anesthe´sie au Canada. Méthode Nous avons re´alise´un sondage auto-administreá upre`s des anesthe´siologistes au Canada en nous fondant sur la liste des membres de la Socie´te´canadienne des anesthe´siologistes. Lors de la mise au point du sondage, nous avons de´termine´des domaines cle´s, notamment les types de pe´nuries de me´dicaments, l'impact sur la capacite´des fournisseurs d'anesthe´sie a`offrir des soins d'anesthe´sie ge´ne´rale, et l'impact sur les devenirs des patients. Nous avons e´value´la validite´apparente, la sensibilite´clinique, et la validited u contenu. Les re´pondants ont reçu le sondage entre janvier et avril 2012. Résultats Au total, 1187 (61,4 %) re´pondants ont comple´ted es questionnaires de façon valable, et 779 (65,7 %) de ces re´pondants ont de´crit une pe´nurie d'un me´dicament ou plus utilise´en anesthe´sie ou en soins critiques. Les changements dans la pratique de l'anesthe´sie dus a`des pe´nuries de me´dicaments e´taient courants; 586 (49 %) re´...

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Section: Discussionmentioning

confidence: 99%

Drug shortages in Canadian anesthesia: a national survey

Hall

Bryson

Flowerdew

et al. 2013

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

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“…15 Based on this information and to detect a minimum difference of one point in pain score and a 15% incidence rate, the sample size was calculated as 160 per group with an alpha = 0.025 and power = 0.80.…”

Section: Sample Size Calculationmentioning

confidence: 99%

Surgical safety checklist: implementation in an ambulatory surgical facility

Morgan

Cunningham

Mitra

et al. 2013

Can J Anesth/J Can Anesth

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Purpose In 2007, the World Health Organization created a Surgical Safety Checklist (SSC) that encompassed a simple set of surgical safety standards. The threefold purpose of this study was to add ambulatory-specific items to the SSC, to introduce the items into an ambulatory surgical facility, and to determine if patient outcomes regarding postoperative pain and nausea/vomiting improved following implementation. In addition, safety attitudes, antibiotic timing, regional anesthesia/nerve blocks, preemptive pain medications, prophylactic antiemetics, length of stay, and hospital admission were also assessed.Methods After Research Ethics Board approval, staff complete a Safety Attitudes Questionnaire. Seven items were added to the SSC. Data were then collected on 180 surgical cases before SSC implementation and 195 cases following implementation. Compliance with each section of the SSC was assessed. Results On postoperative day one, the median (97.5% confidence interval [CI]) difference between pre-and postimplementation pain scores was 0.5 (97.5% CI, 0 to 1; P = 0.13), and the median difference in the rate of postdischarge nausea/vomiting was -8.4% (97.5% CI, -17.9 to 1.1; P = 0.06). There was no improvement in safety attitudes or any of the secondary outcomes, with the exception of the use of preemptive pain medications. Compliance with the three sections of the checklist, i.e., BRIEFING, TIME OUT, and DEBRIEFING was 99.49%, 97.95%, and 96.92%, respectively. There was low compliance in verbalization of the added ''ambulatory-specific items''. Conclusion Potential reasons for lack of uptake and integration include poor ''user'' buy-in, an overly lengthy checklist, and lack of prioritization of ambulatory-specific items. A shortened SSC was developed based on the results of this study. This trial was registered at ClinicalTrials.gov ID: NCT00934310.Author contributions Pamela J. Morgan was involved in the acquisition of funding for this study. Pamela J. Morgan Lisa Cunningham, Wei Wu, Victoria Noguera, and John Semple were involved in the conception and design of the study. Lisa Cunningham, Sohini Mitra, Natalie Wong, and Mary Li were involved in the acquisition of data for the study. Pamela J. Morgan was involved in the interpretation of the data. Pamela J. Morgan, Wei Wu, and Mary Li analyzed the data. Pamela J. Morgan, Lisa Cunningham, and Mary Li were involved in drafting the article. Sohini Mitra, Natalie Wong, Wei Wu, Victoria Noguera, and John Semple were involved in the critical revision of the article. Résumé Objectif En 2007, l'Organisation mondiale de la Sante´a cre´e´une Liste de contrôle de la se´curite´chirurgicale (LCSC) couvrant un ensemble simple de normes de se´curite´pour la chirurgie. L'objectif triple de cette e´tude e´tait d'ajouter des e´le´ments spe´cifiques au contexte ambulatoire a`la LCSC, d'introduire ces e´le´ments dans un centre de chirurgie ambulatoire, et de de´terminer si les devenirs des patients en matie`re de douleur et de nause´es et vomissements postope´ratoires e´taien...

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“…Acupressure is one of the non-pharmacological methods which can prevent PONV. Several studies have shown that it was an effective method which could be used for the management of PONV 5,6 . The mechanism of action of Acupressure is still unclear.…”

Section: Resultsmentioning

confidence: 99%